b. Transfers/Relocations Within the Institution

The bed reservation clerk, in consultation with the nurse on the unit, assigns patients to beds for in-house transfers. If disagreement occurs, the appropriate supervisor will be notified. See Clinical Programs Policy Inpatient Admissions, Discharges and Internal Transfer - MS 5.01 and Transfer of Patients between Units - Addendum G.2.

c. Discharges/Transfers Out of Institution

1. Patients are discharged only on the written and signed order of a physician. Refer to Clinical Programs Policy Inpatient Admissions, Discharges and Internal Transfer - MS 5.01 for the following policies:

1. Patients leaving the hospital against medical advice
2. Patients who are being transported to another facility for care or treatment
3. Patients who are granted a leave of absence

2.     Transfer of patients to another facility for inpatient care is coordinated with the inpatient facilities on an individual basis. Contact the Access Team and Nursing Administrator on duty for assistance. Refer to Acute Care Facility to Acute Care Facility Transfer Policy - MS 5.04.

d. Closure of Inpatient Beds

1. The closing of a bed on an inpatient unit is a very serious decision that is done only after all other options have failed. It is considered an emergency to close any bed for any reason and should be performed only with formal approval.

G.4  Closure of Beds

2. The person with the ultimate authority to authorize bed closure is the Hospital Administrator on call. This may be done only after the following has occurred:

The Director or ADON has reviewed the situation and conferred with the Clinical Services Manager for options.

And

The Chief Nursing Officer (CNO) has been contacted (when she is not available, the Director representing the CNO in her absence will be contacted) to review the options that have been discussed.

2. Outpatient Operations

1. Admission to the Clinic – It is the responsibility of the assigned RN to coordinate clinical flow and to notify physicians of the arrival, status and location of all patients.
2. Nursing Responsibilities of Clinic Patients:

1. Completion of the initial admission assessment
2. Problem identification
3. Patient education
4. Discharge instructions
5. Follow-up plan

3. The RN is responsible for communication to appropriate inpatient services on patient status for needed procedure and/or hospital admission in accordance with UAMS Policy Inpatient Admissions, Discharges and Internal Transfer MS 5.01.  Patient Hand Off Communications MS 5.17

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